2.08 - Complications of Chronic Kidney Disease

Question 1

What are the complications resulting from sodium retention?

Answer 1

Volume expansion
Peripheral oedema
Hypertension

Question 2

What are the treatments of hypertension in patients with CKD?

Answer 2

Any antihypertensive but salt restriction and diuretics are also required
However with decreased filtrate produced, decreased diuretic reaches the loop of henle, therefore greater doses of diuretic are required for patients with increasing severity of CKD

Question 3

What are the complications of potassium retention?

Answer 3

Hyperkalaemia –> depolarises cell membranes –> bradycardia, conduction delays, cardiac arrest and skeletal muscle weakness

Question 4

What sort of drugs can cause potassium retention?

Answer 4

ACE Inhibitors
AT1R blockers
Beta blockers
Spironolactone
Fibre supplements

Question 5

Where is most of the bodies potassium located?

Answer 5

Intracellularly (4200mmol intra- compared to 56mmol extracellularly)

Question 6

What are some complications of phosphate retention?

Answer 6

Secondary hyperparathyroidism

Vascular calcification

Question 7

What are the effects of Parathyroid hormone on blood calcium?

Answer 7

PTH increases renal reabsorption in the kidney and increases mobilisation of calcium from bone by increasing activity of osteoclasts.
It also increases renal calcitriol production which results in increased calcium absorption in the gut

Question 8

What are some of the treatments for high phosphate?

Answer 8

Dietary restriction
Phosphate binders
Vitamin D minimisation
Correct hyperparathyroidism

Question 9

What are the consequences of an inability to excrete acid in CKD?

Answer 9

Chronic acidaemia
Dissolution of bones
Malaise
Catabolism